Epidemiology, clinical characteristics, and virologic features of COVID-19 patients in Kazakhstan: A nation-wide retrospective cohort study

Yegorov, Sergey; Goremykina, Maiya; Иванова, Р; Good, Sara V.; Babenko, Dmitriy; Shevtsov, Alexandr; MacDonald, Kelly S.; Zhunussov, Yersin

doi:10.1016/j.lanepe.2021.100096

Cited by 32 publications

(41 citation statements)

References 27 publications

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“…Consistently, severity of the disease, which is judged upon the abnormality of these clinical symptoms, was also associated with increased odds of death. These findings are consistent with previously reported [ 2 ]. It is important to note that these characteristics in general are easily obtained in a hospital or outpatient, and if abnormal should prompt further testing to make a decision regarding hospital admission.…”

Section: Discussionsupporting

confidence: 94%

“…Often the most severe cases and critically ill patients were referred to our hospital, which has sufficient experience and equipment to provide advanced floor and ICU care. This could explain why the case fatality rate in our study 3–4 folds was higher than nationwide or worldwide COVID-19 fatality rate of 3–4% [ 2 , 13 ].…”

Section: Discussionmentioning

confidence: 53%

“…The first registered case of COVID-19 in Kazakhstan was identified on March 13 th 2020 followed by an introduction of a country-wide state of emergency on March 16 th 2020 [ 2 , 3 ]. During that time Kazakhstani healthcare facilities have suddenly been overwhelmed with COVID-19 cases, which resulted in critical filling of infectious hospitals with patients all over Kazakhstan [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Mortality predictors of hospitalized patients with COVID-19: Retrospective cohort study from Nur-Sultan, Kazakhstan

Pya¹,

Bekbossynova²,

Gaipov

et al. 2021

PLoS ONE

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Background First reported case of Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in Kazakhstan was identified in March 2020. Many specialized tertiary hospitals in Kazakhstan including National Research Cardiac Surgery Center (NRCSC) were re-organized to accept coronavirus disease 2019 (COVID-19) infected patients during summer months of 2020. Although many studies from worldwide reported their experience in treating patients with COVID-19, there are limited data available from the Central Asia countries. The aim of this study is to identify predictors of mortality associated with COVID-19 in NRCSC tertiary hospital in Nur-Sultan, Kazakhstan. Methods This is a retrospective cohort study of patients admitted to the NRCSC between June 1st–August 31st 2020 with COVID-19. Demographic, clinical and laboratory data were collected from electronic records. In-hospital mortality was assessed as an outcome. Patients were followed-up until in-hospital death or discharge from the hospital. Descriptive statistics and factors associated with mortality were assessed using univariate and multivariate logistic regression models. Results Two hundred thirty—nine admissions were recorded during the follow-up period. Mean age was 57 years and 61% were males. Median duration of stay at the hospital was 8 days and 34 (14%) patients died during the hospitalization. Non-survivors were more likely to be admitted later from the disease onset, with higher fever, lower oxygen saturation and increased respiratory rate compared to survivors. Leukocytosis, lymphopenia, anemia, elevated liver and kidney function tests, hypoproteinemia, elevated inflammatory markers (C-reactive protein (CRP), ferritin, and lactate dehydrogenase (LDH)) and coagulation tests (fibrinogen, D-dimer, international normalized ratio (INR), and activated partial thromboplastin time (aPTT)) at admission were associated with mortality. Age (OR 1.2, CI:1.01–1.43), respiratory rate (OR 1.38, CI: 1.07–1.77), and CRP (OR 1.39, CI: 1.04–1.87) were determined to be independent predictors of mortality. Conclusion This study describes 14% mortality rate from COVID-19 in the tertiary hospital. Many abnormal clinical and laboratory variables at admission were associated with poor outcome. Age, respiratory rate and CRP were found to be independent predictors of mortality. Our finding would help healthcare providers to predict the risk factors associated with high risk of mortality. Further investigations involving large cohorts should be provided to support our findings.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

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Mortality predictors of hospitalized patients with COVID-19: Retrospective cohort study from Nur-Sultan, Kazakhstan

Pya¹,

Bekbossynova²,

Gaipov

et al. 2021

PLoS ONE

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“…In our cohort, serologically confirmed exposure to COVID-19 was associated with self-documented history of respiratory illness, most of which was dated by the participants to the peak of the first COVID-19 wave in the Spring-Summer of 2020 1 , period during which the country’s healthcare system was overwhelmed and laboratory testing was limited 3 . This timing of self-reported illness suggests that anti-S immunoglobulins remain detectable up to a year after symptomatic COVID-19, consistent with the established long-term persistence of SARS-CoV-2-reactive antibodies 13,14 .…”

Section: Discussionmentioning

confidence: 89%

Prevalence of anti-SARS-CoV-2 immunity in Kazakhstan before the launch of COVID-19 vaccination

Kadyrova

Yegorov

Negmetzhanov

et al. 2021

Preprint

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Background: COVID-19 exposure in Central Asia appears underestimated and SARS-CoV-2 seroprevalence data are urgently needed to inform ongoing vaccination efforts and other strategies to mitigate the regional pandemic. Here, we assessed the prevalence of anti-SARS-CoV-2 antibody-mediated immunity in a heterogeneous cohort of public university employees in Karaganda, Kazakhstan. Methods: Asymptomatic subjects (n=100) were randomly recruited prior to their first COVID-19 vaccination. Questionnaires were administered to capture a range of demographic and clinical characteristics. Nasopharyngeal swabs were collected for SARS-CoV-2 RT-qPCR testing. Serological assays were performed to detect spike (S)-reactive IgG and IgA. Results: Anti-S IgG and IgA seropositivity rates among SARS-CoV-2 PCR-negative participants (n=100) were 42% and 53%, respectively, and 61% of subjects tested positive for at least one of the antibodies. Serologically confirmed history of COVID-19 was associated with self-reported history of respiratory illness since March 2020 (p<0.001). Conclusions: SARS-CoV-2 exposure in this cohort is ~15-fold higher compared to the reported all-time national and regional COVID-19 prevalence. Continuous serological surveillance is critical for understanding the COVID-19 transmission dynamics and should be nationally implemented to better inform the public health response in Central Asia.

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“…Hospital visits by such patients during the coronavirus disease -2019 (COVID-19) pandemic may have poor outcomes. This cohort of patients is more severely affected and at risk of death if infected [4]. Therefore, remote management of such patients is now the most appropriate.…”

Section: Introductionmentioning

confidence: 99%

Home Management of the Device Detected Atrial Fibrillation during COVID-19 Pandemic: A Case Report

Rakhimova

Хайбуллин

Smail

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: Patients with heart failure (HF) and implanted heart devices constitute a vulnerable category during the coronavirus disease –2019 (COVID-19) pandemic. The remote monitoring function allows the physician to detect atrial fibrillation (AF) in these patients and to prevent thromboembolic complications by prescribing anticoagulants. Under quarantine conditions, such patients can receive fully remote consultation and treatment, which will protect them from the risk of infection, and also reduce the burden on medical institutions. CASE REPORT: A 56-year-old man presented to the clinic with shortness of breath when climbing the second floor, moderate non-specific fatigue, general weakness, and a decrease in exercise tolerance. The patient received standard treatment for HF for at least 3 months (ACEI, beta blockers, MR antagonists, and loop diuretics) in individually selected adequate doses. ECG on admission showed a QRS of 150 ms, left bundle branch block (LBBB). Echo showed dilatation of all heart chambers, diffuse hypokinesis of the walls with akinesis of the apical, middle anterior LV segments, as well as hypokinesis of the basal, middle apical, and anterior septal segment of the LV. The ejection fraction was reduced to 35%. RV function is reduced. After a detailed discussion with the team, it was decided to do implantation of a cardioverter-defibrillator with resynchronization function, equipped with remote monitoring (Biotronik, and Home monitoring). Date of implantation is June 19, 2014. Due to the fact that the patient was connected to the remote monitoring system, May 5, 2020, he was diagnosed with asymptomatic AF. The episode lasted 1 min 22 s. On the following days of monitoring, episodes of AF were also recorded. The duration of the episodes ranged from a few seconds to 12 h/day. The patient received a doctor’s consultation through phone call, his risk of stroke was four when assessed using the CHA2DS2VASc scale. In treatment, it was recommended to add antiarrhythmic drugs (amiodarone 600 mg a day) and oral anticoagulants (rivaroxaban 20 mg × 1 time/day). Later, periodic IEGM showed absence of AF. CONCLUSION: In the context of the COVID-19 pandemic, health-care providers should rethink their approach to managing patients with implanted heart devices. Modern cardiovascular implantable electronic devices allow the physician to monitor the status of patients and immediately respond to situations requiring a change in treatment. Consultations can be carried out completely online.

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Epidemiology, clinical characteristics, and virologic features of COVID-19 patients in Kazakhstan: A nation-wide retrospective cohort study

Cited by 32 publications

References 27 publications

Mortality predictors of hospitalized patients with COVID-19: Retrospective cohort study from Nur-Sultan, Kazakhstan

Mortality predictors of hospitalized patients with COVID-19: Retrospective cohort study from Nur-Sultan, Kazakhstan

Prevalence of anti-SARS-CoV-2 immunity in Kazakhstan before the launch of COVID-19 vaccination

Home Management of the Device Detected Atrial Fibrillation during COVID-19 Pandemic: A Case Report

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